The study involved a prospective cohort of 2,470 Kaiser Permanente patients with stage I to III colorectal cancer diagnosed from 2006 through 2011. Systemic inflammation was measured as neutrophil-to-lymphocyte ratio and was averaged for the 24 months before diagnosis, with a mean of 3 measurements and a mean time before diagnosis of 7 months. Neutrophil-to-lymphocyte ratio < 3 indicated low or no inflammation. Skeletal muscle index (muscle area at the third lumbar vertebra divided by squared height) was calculated from computed tomography scans at diagnosis, with sarcopenia defined as < 52 cm2/m2and < 38 cm2/m2 for normal or overweight men and women and < 54 cm2/m2 and < 47 cm2/m2 for obese men and women, respectively. In total, 49% of patients were women, and the mean age was 63 years.

The investigators concluded: “Prediagnosis inflammation was associated with at-diagnosis sarcopenia. Sarcopenia combined with inflammation nearly doubled risk of death, suggesting that these commonly collected biomarkers could enhance prognostication. A better understanding of how the host inflammatory/immune response influences changes in skeletal muscle may open new therapeutic avenues to improve cancer outcomes.”